Tuesday’s election results have been widely interpreted as a rejection of big government – but even those who endorse this view want protection when public health is at risk. That’s why it was so dismaying to see how the state mishandled last week’s announcement that an infected food service worker in Cumberland County may have exposed diners to hepatitis A.

Hampered by a lack of staff in key positions, Maine Center for Disease Control and Prevention officials withheld information that the public needs in order to assess the level of risk posed by the contagious foodborne virus. As the LePage administration plans for its second term, it should prioritize fully staffing the CDC to ensure that it’s ready to act quickly and effectively in the face of communicable disease.

Hepatitis A causes an acute liver infection that can sicken a patient for weeks or months; in some cases, it can even lead to death. One of the most common ways the virus is spread is through consuming food or water that an infected person has handled. So it’s natural that Mainers would want to know where the potential exposure took place.

But the state has refused to name the restaurant, saying that to do so would “risk identifying” the employee, thus violating patient privacy laws. This is a puzzling departure from previous practice; last year, the Maine CDC identified the site of a church supper where about 100 people were potentially exposed to the virus. And in 2008, a state alert about a cluster of hepatitis A cases noted that several of those affected were students at the same school, which the state named.

The state has also emphasized that it didn’t learn of the potential Cumberland County exposure until after a 14-day window for restaurant patrons to receive a preventive vaccine. But naming the site is still a valid protective measure. Because the symptoms of hepatitis A can mimic the signs of flu or chronic fatigue, people who know they may have been exposed to the virus are more likely than others to raise the possibility with their doctor and receive the right diagnosis and treatment.

Deciding what information to release is one of the more complex tasks on the state’s agenda whenever it hears about a potential disease exposure. In this case, making these decisions has been even more of a challenge because critical infectious-disease positions within the agency are vacant.

They include Maine’s hepatitis coordinator and the state epidemiologist, who oversees the state’s efforts to prevent and respond to infectious-disease outbreaks and tracks their cause and impact. (The position of deputy state epidemiologist also remains unfilled.)

Meanwhile, after several years of attrition, the ranks of the state’s public health nurses – the front-line workers who run vaccination clinics and respond to outbreaks – are down by over 25 percent.

Protecting the well-being of the people of the state of Maine should be a priority for the government of the state of Maine. So it’s imperative for Maine’s public health agency to be fully equipped and willing to carry out its mission.


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